I've been reading lately about the benefits of clinical trials. I am treatment naive with a VL of 15,000 and TC 650 diagnosed in 11/02, neg in 6/01. Should I participate in one of these trials even though my numbers indicate I probably shouldn't start treatment yet? Would the clinical trial be better then what's currently out there? I know it's important to get the first treatment right, so how do I know the clinical trial is the best choice for me if I do participate? I also read that in some of these trials, you get a placebo, isn't that bad if I need to be on treatment?

Thanks!

Response from Dr. Young

Thanks for your question and interest in clinical trials.

In general, I advise my patients as follows: if I wouldn't recommend starting treatment because of your CD4 or viral load, then I wouldn't recommend a clinical trial.

That said, persons who enroll in clinical trials tend to have much better drug performance and fewer side effects than those who don't-- I think that this is not because of better drugs, per se, but rather better attention to adherence and care.

All current clinical trials that include placebo, do so mostly to confuse the investigators and doctors as to which medications that the study subjects are taking, not to permit anyone to receive suboptimal treatments. Another way of saying this is that a typical study might look at two different 3-drug regimens, but include a 4th pill- placebo; all patients will receive 3 active drugs and a single placebo.

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